Clinical effect of Mongolian medicine Qinggan Jiuwei powder in treatment of alcoholic liver fibrosis
-
摘要: 目的观察蒙药清肝九味散对酒精性肝纤维化患者影像学指标的改善情况,探讨清肝九味散治疗肝纤维化的疗效。方法收集2015年10月-2017年1月期间内蒙古通辽市科尔沁区第一人民医院消化内科病房及门诊就诊的酒精性肝纤维化患者104例,随机分为试验组(n=52)和对照组(n=52)。实验组给予蒙药清肝九味散,对照组给予还原型谷胱甘肽片。收集患者治疗前、后的肝功能指标、肝脾超声检查结果及Fibro Scan检测的肝硬度值(LSM)。符合正态分布的计量资料组间比较采用独立样本t检验,组内比较采用配对样本t检验;非正态分布的计量资料组间比较采用Wilcoxon秩和检验。结果 2组患者临床症状及体征均有不同程度改善,试验组与对照组患者治疗前后ALT、AST、GGT、LSM水平比较差异均有统计学意义(试验组:Z值分别为-3.09、-7.19、-8.27,t=7.13,P值分别0.002、<0.001、<0.001、<0.001;对照组:Z值分别为-3.28、-4.60、-5.06,t=8.54,P值分别为0.001、<0.001、<0.001、<0.001);治疗后试验...Abstract: Objective To observe the clinical effect of Mongolian medicine Qinggan Jiuwei powder in the treatment of alcoholic liver fibrosis by observing the improvement in imaging indices. Methods A total of 104 patients with alcoholic liver fibrosis who visited Department of Gastroenterology in Horqin District First People's Hospital in Tongliao from October 2015 to January 2017 were enrolled and randomly divided into experimental group and control group, with 52 patients in each group. The patients in the experimental group were given Mongolian medicine Qinggan Jiuwei powder, while those in the control group were given reduced glutathione tablets. Liver function parameters, liver-spleen ultrasound findings, and liver stiffness measurement ( LSM) determined by Fibro Scan were observed before and after treatment. The independent samples t-test was used for comparison of normally distributed continuous data between groups, and the paired samples t-test was used for comparison within each group; the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between groups. Results Both groups had varying degrees of improvements in clinical symptoms and signs. Both groups had significant changes in alanine aminotransferase, aspartate aminotransferase ( AST) , gamma-glutamyl transpeptidase ( GGT) , and LSM after treatment ( experimental group: Z =-3. 09, -7. 19, and-8. 27, t = 7. 13, P = 0. 002, < 0. 001, < 0. 001, and < 0. 001; control group: Z =-3. 28, -4. 60, and-5. 06, t = 8. 54. P = 0. 001, < 0. 001, < 0. 001, and < 0. 001) . There were significant differences in AST and GGT after treatment between the two groups ( Z =-2. 02 and-2. 15, P = 0. 04 and 0. 03) . Both groups had significant changes in oblique diameter of the right liver lobe, diameter of the portal vein, blood flow rate of the portal vein, spleen thickness, and diameter of the splenic vein after treatment ( experimental group: t = 6. 48, 11. 02, 2. 20, 3. 30 and 5. 30, P < 0. 001, < 0. 001, = 0. 030, < 0. 001, and < 0. 001;control group: t = 3. 51、6. 31、2. 68、3. 06、4. 71, P = 0. 01, < 0. 001, = 0. 01, < 0. 001, and < 0. 001) . There were significant differences in oblique diameter of the right liver lobe and diameter of the portal vein after treatment between the two groups ( t = 3. 96 and 3. 53, P = 0. 02 and 0. 01) . Conclusion Mongolian medicine Qinggan Jiuwei powder has a good clinical effect in the treatment of alcoholic liver fibrosis and can effectively reduce the imaging index LSM and values measured by abdominal color Doppler ultrasound in patients with alcoholic liver fibrosis.
-
[1]ZHU C, QI X, LI H, et al.Correlation of serum liver fibrosis markers with severity of liver dysfunction in liver cirrhosis:a retrospective cross-sectional study[J].Int J Clin Exp Med, 2015, 8 (4) :5989-5998. [2]WEI S, NIU M, WANG J, et al.A network pharmacology approach to discover active compounds and action mechanisms of San-Cao Granule for treatment of liver fibrosis[J].Drug Des Devel Ther, 2016, 10:733-743. [3]Fatty Liver and Alcoholic Liver Disease Study Group of the Chinese Liver Disease Association, Chinese Medical Association.Guidelines for prevention and treatment of alcoholic liver disease (revised version 2010) [J].J Clin Hepatol, 2010, 26 (3) :229-232. (in Chinese) 中华医学会肝病学分会脂肪肝和酒精性肝病学组.酒精性肝病诊疗指南 (2010年修订版) [J].临床肝胆病杂志, 2010, 26 (3) :229-232. [4]CHEN GF, LI B, CHEN SH.Research in the progress of non-invasive diagnosis of liver fibrosis[J].Med Res, 2011, 40 (4) :15-18. (in Chinese) 陈国凤, 李冰, 陈松海.肝纤维化无创性诊断的研究进展[J].医学研究杂志, 2011, 40 (4) :15-18. [5]Expert Committee on Clinical Application of Instantaneous Elastic Imaging Technology (TE) .Instantaneous elastic imaging technology (te) expert advisor on clinical applications (2015) [J/CD].Chin J Liver Dis:Electronic Edition, 2015, 7 (2) :12-18. (in Chinese) 瞬时弹性成像技术 (TE) 临床应用共识专家委员会.瞬时弹性成像技术 (TE) 临床应用专家共识 (2015年) [J/CD].中国肝脏病杂志:电子版, 2015, 7 (2) :12-18. [6] CE SRZB.Mongolian internal medicine[M].Hohhot:Inner Mongolia People's Publishing House, 2011:187, 196. (in Chinese) 策·苏荣扎布.蒙医内科学[M].呼和浩特:内蒙古人民出版社, 2011:187, 196. [7] MA HYN, BI LZN.Medication on the Mongolian version (M) .Chifeng:Inner Mongolia Science and Technology Press, 1985:165-166. (in Chinese) 马哈也那, 比卢遮那.医药月帝 (蒙文版) (M) .赤峰:内蒙古科学技术出版社, 1985:165-166. [8]YUTUO YDGB.Four medical code[M].Shanghai:Shanghai Science and Technology Press, 1987:145-146, 169-170. (in Chinese) 宇妥·元丹贡布.四部医典[M].上海:上海科学技术出版社, 1987:145-146, 169-170. [9]BAI QY, CE SRZB, SU HBLG.Chinese Medical Encyclopedia (Mongolian Medicine) [M].Shanghai:Shanghai science and Technology Press, 1992:125, 269. (in Chinese) 白清云, 策·苏荣扎布, 苏和毕力格.中国医学百科全书 (蒙医学) [M].上海:上海科学技术出版社, 1992:125, 269. [10]HASI QQG, SE TY.Treatment of alcoholic liver fibrosis with Mongolian medicine[J].J Med Pharm Chin Minorities, 2013, 6 (35) :21-22. (in Chinese) 哈斯其其格, 色图雅.酒精性肝纤维化的蒙医治疗[J].中国民族医药杂志, 2013, 6 (35) :21-22. [11]ZHONG ZZ, YU QL.Self-made Xingpi yanggan decoction in treatment of liver function and related parameters of liver fibrosis due to alcoholic liver disease[J].Chin Arch Tradit Chin Med, 2017, 3:752-754. (in Chinese) 钟之洲, 郁清琳.醒脾养肝汤治疗酒精性肝病对肝功能、肝纤维化相关指标的影响[J].中华中医药学刊, 2017, 3:752-754. [12]GE HY, ZHAO BS, ZHANG SH, et al.Clinical effect of Mongolian drug Qinggan Jiuwei powder in treatment of alcoholic hepatitis[J].J Clin Hepatol, 2016, 32 (10) :1947-1950. (in Chinese) 戈宏焱, 赵百岁, 张仕华, 等.蒙药清肝九味散治疗酒精性肝炎的效果观察[J].临床肝胆病杂志, 2016, 32 (10) :1947-1950. [13]YIN P, CUI HR, ZHANG CE, et al.Protective effects of Liuwei Wuling tablet on acute alcoholic-induced liver injury in mice[J].China J Chin Mater Med, 2016, 41 (19) :3637-3642. (in Chinese) 尹萍, 崔鹤蓉, 章从恩, 等.六味五灵片对小鼠急性乙醇性肝损伤的保护作用及机制初步研究[J].中国中药杂志, 2016, 41 (19) :3637-3642. [14]WANG XL, LU BJ.Ruan Gan granule in mice caused by carbon tetrachloride liver fibrosis model[J].J Changchun Univ Chin Med, 2015, 31 (5) :911-913. (in Chinese) 王学良, 卢秉久.软肝冲剂对四氯化碳所致小鼠肝纤维化模型的影响[J].长春中医药大学学报, 2015, 31 (5) :911-913. [15]WANG XQ, TIAN QQ, LI YH, et al.Immunoregulatory effect of Buyang Huanwu decoction on experimental autoimmune encephalomyelitis mice[J].Chin J Immunol, 2017, 33 (1) :52. (in Chinese) 王晓庆, 田倩倩, 李艳花, 等.补阳还五汤对EAE小鼠免疫调节的作用[J].中国免疫学杂志, 2017, 33 (1) :52. [16]WANG ZW, SHAO J, GUO M, et al.Effect of total flavonoids and alkaloids from Meconopsis quintuplinervia on hepatic fibrosis in rat[J].Chin Tradit Patent Med, 2013, 35 (6) :1125-1128. (in Chinese) 王志旺, 邵晶, 郭玫, 等.五脉绿绒蒿总黄酮和总生物碱抗大鼠肝纤维化[J].中成药, 2013, 35 (6) :1125-1128.
本文二维码
计量
- 文章访问数: 2270
- HTML全文浏览量: 20
- PDF下载量: 395
- 被引次数: 0